This within-subject repeated-measures study investigated dual-task postural stability in women with premenstrual syndrome (PMS) by comparing performance during the PMS and non-PMS phases of the menstrual cycle. The study also examined the relationship between PMS symptom severity and dual-task postural stability.
Among women of reproductive age, premenstrual syndrome (PMS) is a common condition. Recent evidence indicates that approximately 20-30% of women experience PMS, highlighting its substantial global impact and confirming that a considerable proportion of women are affected by clinically relevant symptoms \[1,2\]. Estimates suggest that about half of women experience PMS. Fatigue, discomfort, impatience, and trouble concentrating are among the physical, emotional, and cognitive symptoms of PMS that can significantly interfere with day-to-day functioning \[3, 4\]. In addition to these well-known consequences that may affect balance and postural control, an increasing amount of evidence suggests that PMS may also affect neuromuscular systems and cognitive function \[5\]. 40 women with regular menstrual cycles and premenstrual symptoms were enrolled. Participants were assessed during the PMS phase, identified 5-7 days before menstruation, and the non-PMS follicular phase (days 7-10). PMS symptom severity was assessed using the 40-item Premenstrual Syndrome Scale (PMSS). Dual-task postural performance was assessed using the Biodex Balance System during static and dynamic conditions. Participants stood barefoot without holding the handrails while performing forward and reverse spelling tasks. Three 30-second trials were performed at Biodex stability levels 6-8, with adequate rest between trials. Primary outcomes included static and dynamic OSI, APSI, and MLSI, while PMS severity was the secondary outcome. Paired \*t\*-tests and Cohen's \*d\* were used to compare the two phases, and Pearson's correlation assessed the relationship between PMS severity and postural stability.
Study Type
OBSERVATIONAL
Enrollment
40
A single group of 40 female participants (18-27 years) with regular menstrual cycles and PMS symptoms, each evaluated under two within-subject conditions.
faculty of physical therapy, Deraya University
Minya, Menia Governorate, Egypt
Static Overall Stability Index (OSI)
Measured using the Biodex Balance System during static dual-task testing (standing while performing a concurrent spelling task), comparing non-PMS vs. PMS phase.
Time frame: Assessed during the PMS phase (5-7 days before menstruation) and the non-PMS (follicular) phase (days 7-10). A within-subject comparison is made.
Static Medial-Lateral Stability Index (MLSI)
Measured using the Biodex Balance System during static dual-task testing (standing while performing a concurrent spelling task). The MLSI represents postural sway in the mediolateral direction during quiet standing. Unit of measurment: Units on a Scale (Biodex Stability Index)
Time frame: Assessed during the PMS phase (5-7 days before menstruation) and the non-PMS follicular phase (days 7-10). Within-subject comparison between the two phases.
Static Anterior-Posterior Stability Index (APSI)
Measured using the Biodex Balance System during static dual-task testing (standing while performing a concurrent spelling task). The APSI represents postural sway in the anterior-posterior direction during quiet standing.
Time frame: Assessed during the PMS phase (5-7 days before menstruation) and the non-PMS follicular phase (days 7-10). Within-subject comparison between the two phases.
Dynamic Overall Stability Index (OSI)
Measured using the Biodex Balance System during dynamic dual-task testing (standing on an unstable platform while performing a concurrent spelling task). The OSI represents overall postural sway and balance control during dynamic conditions.
Time frame: Assessed during the PMS phase (5-7 days before menstruation) and the non-PMS follicular phase (days 7-10). Within-subject comparison between the two phases.
Dynamic Medial-Lateral Stability Index (MLSI)
Measured using the Biodex Balance System during dynamic dual-task testing (standing on an unstable platform while performing a concurrent spelling task). The MLSI represents postural sway in the mediolateral direction during dynamic conditions.
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Time frame: Assessed during the PMS phase (5-7 days before menstruation) and the non-PMS follicular phase (days 7-10). Within-subject comparison between the two phases.
Dynamic Anterior-Posterior Stability Index (APSI)
Measured using the Biodex Balance System during dynamic dual-task testing (standing on an unstable platform while performing a concurrent spelling task). The APSI represents postural sway in the anterior-posterior direction during dynamic conditions.
Time frame: Assessed during the PMS phase (5-7 days before menstruation) and the non-PMS follicular phase (days 7-10). Within-subject comparison between the two phases.
Premenstrual Syndrome (PMS) Symptom Severity
Assessed using the Premenstrual Syndrome Scale (PMSS), a validated 40-item, five-point scale (never to always) covering physiological, psychological, and behavioural symptoms. Total scores range from 40 to 200, with higher scores indicating greater symptom severity. This measure is used to examine the correlation between symptom severity and postural performance.
Time frame: Administered during both the non-PMS (follicular) phase (days 7-10) and the PMS phase (5-7 days before menstruation).